Provider Demographics
NPI:1508353491
Name:KADRI, MOHAMED HILAL (MED)
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:HILAL
Last Name:KADRI
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 W CENTINELA AVE STE 380
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6367
Mailing Address - Country:US
Mailing Address - Phone:310-337-7827
Mailing Address - Fax:
Practice Address - Street 1:6101 W CENTINELA AVE STE 380
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6367
Practice Address - Country:US
Practice Address - Phone:310-337-7827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-17
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-32478103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst